Sigba, Juliana R.

HRN: 11-25-97  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/23/2024
CEFTRIAXONE 1G (VIAL)
05/23/2024
05/30/2024
IVT
2g
OD
CAP MR
Waiting Final Action 
05/23/2024
AZITHROMYCIN 500MG TABLET (TAB)
05/23/2024
05/28/2024
ORAL
500mg
OD
CAP MR
Waiting Final Action 
06/01/2024
LEVOFLOXACIN 500MG (TAB)
06/01/2024
06/08/2024
PO
500mg
OD
CAP-MR
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: